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Brandaleone L, Franchellucci G, Facciorusso A, Samanta J, Moon JH, Vargas-Madrigal J, Robles Medranda C, Barbera C, Di Matteo F, Bulajic M, Auriemma F, Paduano D, Calabrese F, Gentile C, Massidda M, Bianchi M, De Luca L, Polverini D, Masoni B, Poletti V, Marcozzi G, Hassan C, Repici A, Mangiavillano B. The Use of a New Dedicated Electrocautery Lumen-Apposing Metal Stent for Gallbladder Drainage in Patients with Acute Cholecystitis. Diagnostics (Basel) 2023; 13:3341. [PMID: 37958236 PMCID: PMC10650170 DOI: 10.3390/diagnostics13213341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
Aims: Lumen-apposing metal stents (LAMSs) in ultrasonography-guided gallbladder drainage (EUS-GBD) have become increasingly important for high-risk surgical patients. Our study aims to evaluate the technical and clinical success, safety, and feasibility of endoscopic ultrasonography-guided gallbladder drainage using a new dedicated LAMS. Methods: This is a retrospective multicenter study that included all consecutive patients not suitable for surgery who were referred to a tertiary center for EUS-GBD using a new dedicated electrocautery LAMS for acute cholecystitis at eight different centers. Results: Our study included 54 patients with a mean age of 76.48 years (standard deviation: 12.6 years). Out of the 54 endoscopic gallbladder drainages performed, 24 (44.4%) were cholecysto-gastrostomy, and 30 (55.4%) were cholecysto-duodenostomy. The technical success of LAMS placement was 100%, and clinical success was achieved in 23 out of 30 patients (76.67%). Adverse events were observed in two patients (5.6%). Patients were discharged after a median of 5 days post-stenting. Conclusions: EUS-GBD represents a valuable option for high-surgical-risk patients with acute cholecystitis. This new dedicated LAMS has demonstrated a high rate of technical and clinical success, along with a high level of safety.
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Affiliation(s)
- Luca Brandaleone
- Digestive Endoscopy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (D.P.); (B.M.); (V.P.); (G.M.); (C.H.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Gianluca Franchellucci
- Digestive Endoscopy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (D.P.); (B.M.); (V.P.); (G.M.); (C.H.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Antonio Facciorusso
- Gastroenterology Unit, Department of Biomedical Science, Foggia University Hospital, 71122 Foggia, Puglia, Italy;
| | - Jayanta Samanta
- Gastroenterology PGIMER, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India;
| | - Jong Ho Moon
- Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon 31538, Republic of Korea;
| | - Jorge Vargas-Madrigal
- Department of Gastroenterology and Endoscopy, Hospital Enrique Baltodano Briceño, Liberia 50101, Costa Rica;
| | - Carlos Robles Medranda
- Instituto Ecuatoriano de Enfermedades Digestivas—IECED, Gastroenterology Av Abel Romero Castillo, Guayaquil 090505, Guayas, Ecuador;
| | - Carmelo Barbera
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Rome, Italy;
| | - Francesco Di Matteo
- GIUnit, Digestive Diseases, Campus Bio Medico University, 00128 Rome, Rome, Italy;
| | - Milutin Bulajic
- Digestive Endoscopy, Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Rome, Italy;
| | - Francesco Auriemma
- Gastrointestinal Endoscopy Unit—Humanitas Mater Domini, 21100 Castellanza, Varese, Italy; (F.A.); (D.P.); (F.C.); (C.G.)
| | - Danilo Paduano
- Gastrointestinal Endoscopy Unit—Humanitas Mater Domini, 21100 Castellanza, Varese, Italy; (F.A.); (D.P.); (F.C.); (C.G.)
| | - Federica Calabrese
- Gastrointestinal Endoscopy Unit—Humanitas Mater Domini, 21100 Castellanza, Varese, Italy; (F.A.); (D.P.); (F.C.); (C.G.)
| | - Carmine Gentile
- Gastrointestinal Endoscopy Unit—Humanitas Mater Domini, 21100 Castellanza, Varese, Italy; (F.A.); (D.P.); (F.C.); (C.G.)
| | - Marco Massidda
- Gastroenterology and Digestive Endoscopy Unit, Mater Olbia Hospital, 07026 Olbia, Sassari, Italy;
| | - Marco Bianchi
- Policlinico Casilino Hospital, 00169 Rome, Rome, Italy;
| | - Luca De Luca
- Endoscopic Unit, ASST Santi Paolo e Carlo, 20142 Milan, Milan, Italy;
| | - Davide Polverini
- Digestive Endoscopy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (D.P.); (B.M.); (V.P.); (G.M.); (C.H.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Benedetta Masoni
- Digestive Endoscopy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (D.P.); (B.M.); (V.P.); (G.M.); (C.H.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Valeria Poletti
- Digestive Endoscopy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (D.P.); (B.M.); (V.P.); (G.M.); (C.H.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Giacomo Marcozzi
- Digestive Endoscopy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (D.P.); (B.M.); (V.P.); (G.M.); (C.H.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Cesare Hassan
- Digestive Endoscopy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (D.P.); (B.M.); (V.P.); (G.M.); (C.H.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Alessandro Repici
- Digestive Endoscopy, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (D.P.); (B.M.); (V.P.); (G.M.); (C.H.); (A.R.)
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Benedetto Mangiavillano
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
- Gastrointestinal Endoscopy Unit—Humanitas Mater Domini, 21100 Castellanza, Varese, Italy; (F.A.); (D.P.); (F.C.); (C.G.)
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Mangiavillano B, Moon JH, Facciorusso A, Di Matteo F, Paduano D, Bulajic M, Ofosu A, Auriemma F, Lamonaca L, Yoo HW, Rea R, Massidda M, Repici A. EUS-guided biliary drainage with a novel electrocautery-enhanced lumen apposing metal stent as first approach for distal malignant biliary obstruction: a prospective study. Endosc Int Open 2022; 10:E998-E1003. [PMID: 35845026 PMCID: PMC9286767 DOI: 10.1055/a-1838-2683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) represents the gold standard for jaundice palliation in malignant biliary obstruction (MBO) patients. Biliary drainage using electrocautery lumen apposing metal stent (EC-LAMS) is currently a well-established procedure when ERCP fails. We aimed to assess the technical and clinical success of a new EC-LAMS as the first approach to the palliation of malignant jaundice due to MBO in patients unfit for surgery. Patients and methods Twenty-five consecutive patients undergoing endoscopic-guided biliary drainage with the new EC-LAMS were prospectively enrolled. Clinical success was defined as bilirubin level decrease > 15 % 24 hours after EC-LAMS placement. Results Mean age was 76.6 ± 11.56 years, and male patients were 10 (40 %). EC-LAMS placement was technically feasible in 24 patients (96 %) and clinical success rate was 100 %. Only one patient (4 %) experienced a misplacement rescued by an immediate second EC-LAMS placement. The mean duration of hospital stay was 4.66 ± 4.22 days. The median overall survival was 7 months (95 % CI 1-7). Conclusions In this preliminary study, the new EC-LAMS seems to allow a single-step palliative endoscopic therapy in patients affected by jaundice due to MBO, with high technical and clinical success and low adverse events. Further large prospective studies are warranted to validate these results.
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Affiliation(s)
- Benedetto Mangiavillano
- Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA), Italy,Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy
| | - Jong Ho Moon
- Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea
| | - Antonio Facciorusso
- Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Danilo Paduano
- Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA), Italy
| | | | - Andrew Ofosu
- Division of Digestive Diseases, University of Cincinnati, Cincinnati, Ohio, United States
| | - Francesco Auriemma
- Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA), Italy
| | - Laura Lamonaca
- Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA), Italy
| | - Hae Won Yoo
- Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea
| | - Roberta Rea
- Digestive Endoscopy, Campus-Bio Medico University, Rome, Italy
| | | | - Alessandro Repici
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy,Humanitas Clinical and Research Center – IRCCS, Rozzano (MI), Italy
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